Breast Feeding and Increased Risk of Colon Cancer: What is the Missing Link?
Authors: Ayokunle T. Abegunde
Journal: Clinical Gastroenterology and Hepatology (2023)

I read with interest the article by Yuan et al,1Yuan C. et al.Clin Gastroenterol Hepatol. 2023; https://doi.org/10.1016/j.cgh.2023.08.023Abstract Full Text Full Text PDF Scopus (1) Google Scholar which highlights a possible downside to World Health Organization and American Academy of Pediatrics breastfeeding recommendations.2Meek J.Y. et al.Pediatrics. 2022; 150e2022057988Google Scholar,3World Health OrganizationBreastfeeding.www.who.int/health-topics/breastfeeding#tab=tab_1Google Scholar Breastfeeding is an early environmental exposure that affects the development of the immune system and the gut microbiome.4Dominguez-Bello M.G. et al.Gastroenterology. 2011; 140: 1713-1719Abstract Full Text Full Text PDF PubMed Scopus (298) Google Scholar,5Abegunde A.T. et al.World J Gastroenterol. 2016; 22: 6296-6317Crossref PubMed Scopus (140) Google Scholar Composition of the gut microbiome is influenced by numerous factors, such as diet, host genetics and phylogeny, antibiotic use, and intestinal inflammation.4Dominguez-Bello M.G. et al.Gastroenterology. 2011; 140: 1713-1719Abstract Full Text Full Text PDF PubMed Scopus (298) Google Scholar,5Abegunde A.T. et al.World J Gastroenterol. 2016; 22: 6296-6317Crossref PubMed Scopus (140) Google Scholar Gut dysbiosis has been linked to inflammatory bowel diseases and colorectal cancer (CRC).5Abegunde A.T. et al.World J Gastroenterol. 2016; 22: 6296-6317Crossref PubMed Scopus (140) Google Scholar The World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for 6 months, and continuing breastfeeding while introducing appropriate foods after 6 months until a child is 2 years old or older.2Meek J.Y. et al.Pediatrics. 2022; 150e2022057988Google Scholar,3World Health OrganizationBreastfeeding.www.who.int/health-topics/breastfeeding#tab=tab_1Google Scholar Yuan et al1Yuan C. et al.Clin Gastroenterol Hepatol. 2023; https://doi.org/10.1016/j.cgh.2023.08.023Abstract Full Text Full Text PDF Scopus (1) Google Scholar showed that having been breastfed was associated with a 23% increased risk of CRC, and the risk of CRC increased with the duration of being breastfed. Weaning represents a crucial nutritional moment in the growth and development of infants, and it can also affect future health.6Nuzzi G. et al.Pediatr Allergy Immunol. 2022; 33: 44-46Crossref PubMed Scopus (5) Google Scholar It is unclear if the study population were exclusively breastfed; by the same token, it is unclear what weaning practices the study population were exposed to during infancy and early childhood. The strength of the association between history of breastfeeding and CRC was statistically significant; however, recall bias, confounding, or effect modification by an undetermined environmental exposure or exposures cannot be excluded. Therefore, more granular data during breastfeeding, weaning, infancy, and childhood are required to understand the possible mechanisms for the observed association between breastfeeding and CRC. Being Breastfed in Infancy and Risk of Colorectal Cancer and Precursor LesionsClinical Gastroenterology and HepatologyPreviewEmerging evidence implicates the importance of perinatal and early-life exposures in colorectal cancer (CRC) development. However, it remains unclear whether being breastfed in infancy is associated with CRC risk in adult life, particularly early adulthood. Full-Text PDF